Prevention of posterior capsule opacification using different intraocular lenses (results of one-year clinical study)

Reda Žemaitienė, Vytautas Jašinskas, Valerijus Barzdžiukas, Gerd U. Auffarth¹

Clinic of Ophthalmology, Kaunas University of Medicine Hospital, Lithuania, ¹Eye Clinic, University of Heidelberg, Germany

Key words: cataract surgery, intraocular lens, posterior capsule opacification, secondary cataract, anterior capsulorrhexis.

Summary. Aim. To evaluate and to compare the preventive effect of different intraocular lenses from different material with a round or sharp optic edge design on posterior capsule opacification.

Methods. Our clinical study included 165 patients. Mean follow-up was 12.4±0.9 months, mean patient age was 67.5±7.8 years. Patients in the group 1 (n=46) were implanted acrylic three-piece hydrophobic intraocular lenses, sharp optic edge (AcrySof, MA3OBA, Alcon), in the group 2 (n=38) – acrylic hydrophobic single piece intraocular lenses, sharp optic edge (AcrySof, SA3OAL, Alcon), in the group 3 (n=39) – silicone three-piece intraocular lenses, sharp optic edge (CeeOn 911A, Pharmacia), and in the group 4 (n=42) – polymethyl methacrylate single piece intraocular lenses, round optic edge (Crystal, 5T, Alcon). The posterior capsule opacification was evaluated for the entire optic and in the central 3-mm zone using EPCO 2000 Software.

Results. Posterior capsule opacification values of the entire optic were 0.002±0.001 in the AcrySof MA3OBA group, 0.007±0.002 in the AcrySof SA3OAL group, 0.002±0.001 in the CeeOn 911A group, 0.029±0.008 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.011±0.005, 0.025±0.006, 0.014±0.005 and 0.122±0.021, respectively, one year after surgery. The intraocular lenses types with sharp-edge design (acrylic and silicone) showed significantly lower posterior capsule opacification values than round-edge optic design polymethyl methacrylate lenses (p<0.05).

Posterior capsule opacification values of the central 3-mm zone were 0.000±0.000 in the AcrySof MA3OBA group, 0.001±0.001 in the AcrySof SA3OAL group, 0.000±0.000 in the CeeOn 911A group, 0.002±0.001 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.0001±0.0001, 0.018±0.007, 0.004±0.002 and 0.028±0.009, respectively, one year after surgery. Posterior capsule opacification values differences between AcrySof MA3OBA and polymethyl methacrylate intraocular lenses’ groups and between CeeOn 911A and polymethyl methacrylate intraocular lenses’ groups one year after cataract surgery were established (p<0.05).

Conclusions. The sharp-edge foldable intraocular lenses types (AcrySof MA3OBA, AcrySof SA3OAL, CeeOn 911A) showed statistically significant difference in posterior capsule opacification values in one-year follow-up time. The effect of these foldable lenses for prevention of posterior capsule opacification is mainly a result of rectangular, sharp-edged optic design, which creates a sharp capsular bend. A role of material of intraocular lenses (hydrophobic acrylate and silicone) in prevention of posterior capsule opacification during one-year follow-up was not established.

Correspondence to R. Žemaitienė, Clinic of Ophthalmology, Kaunas University of Medicine Hospital, Eivenių 2, 50010 Kaunas, Lithuania. E-mail: redazem@centras.lt

Received 12 February 2004, accepted 13 May 2004